Report finds benefits to foreign accreditation

Task force still has questions about accreditation process
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An AVMA task force assigned to evaluate the impact of the AVMA Council on Education’s accreditation of foreign veterinary schools concluded that the practice benefits U.S. and foreign practitioners alike.

At the same time, members of the AVMA Task Force on Foreign Veterinary School Accreditation requested further clarification of some accreditation standards, demonstrating the complicated nature of the accreditation process.

The task force’s 25-page report was released May 2 after the AVMA Executive Board gave the green light during its April 18-20 meeting.

A student at Ross University School of Veterinary Medicine practices her surgical skills on a Rossie model. The AVMA Executive Board will discuss in June whether to continue accrediting foreign veterinary schools such as Ross'. (Courtesy of Ross University SVM)

Board members planned to listen to feedback from the council, AVMA House of Delegates, and AVMA members before discussing, at their June 6-8 meeting, whether to continue foreign school accreditation.

Global health network

The task force was created by the AVMA Executive Board in response to concerns expressed by the Texas VMA, which submitted two resolutions—one in 2010 and another in 2011—to the House of Delegates asking for a review of the COE’s accreditation of foreign veterinary schools. The 2011 resolution was passed by the HOD, and the AVMA Executive Board created the 11-member task force in August 2011.

Once task force members set to work, they quickly realized that evaluating the impact of foreign school accreditation on the veterinary workforce in the U.S. was not part of their charge, in that the COE cannot consider workforce or economic issues when making accreditation decisions.

Doing so could jeopardize the council’s recognition by the U.S. Department of Education as an accreditor of veterinary schools. Further, it could raise concerns that the AVMA was acting in an anti-competitive manner and invite legal and liability issues for the Association.

“I think some people were hoping maybe the accreditation process may be a way of stopping international schools from being accredited, but the COE can’t consider that,” said Dr. James R. Coffman, former dean of Kansas State University College of Veterinary Medicine and chair of the task force. “People are becoming more aware that they’re not issues that can be related to accreditation. This will not alleviate concerns, but it will at least not tie it to the accreditation process.”

Instead, the task force focused on other areas. Dr. Coffman said the most important area of consensus for the task force members was that international accreditation has many important features. According to the report, some of the impacts of international accreditation include the following:

  • Providing a leadership role in shaping world veterinary medical standards to the benefit of the entire profession, including the veterinary profession the United States.
  • Improving human and animal health in the United States by addressing emergent and zoonotic diseases, food safety, and public health on a global basis.
  • Improving the overall veterinary infrastructure around the globe.

“For example, (foreign accreditation) creates a network of institutions that are well-acquainted and have reliable certification in teaching entry-level students, which contributes to an international network of veterinary expertise” that is needed in cases where diseases cross borders, Dr. Coffman said.

Furthermore, the report showed that for the 4,214 students who took the North American Veterinary Licensing Examination in 2012, the pass rate for students from COE-accredited schools was about 92 percent, but just 37 percent for students from nonaccredited schools.

“This strongly suggests that foreign school accreditation accurately identifies schools with a high quality of education, as measured by the NAVLE,” according to the report.

From 1997-1999, the COE stopped considering new applications while the AVMA reappraised the program. The Task Force on Foreign Veterinary Medical Education eventually recommended that the program continue—with the addition of a policy requiring full cost-recovery of expenses related to the accreditation process—and that the AVMA accept a leadership role in international veterinary medicine, citing as reasons globalization, emerging zoonotic diseases, and food safety concerns.

Dr. Donald G. Simmons, director of the AVMA Education and Research Division from 1996-2007, can attest to this fact, saying the schools that received accreditation were as good as, or better than, some U.S. veterinary institutions.

“The council did not in any way go out and recruit institutions or anything like that. The council just responded to requests from foreign institutions, and accreditation is based solely on their ability to comply with the standards,” he said.

Dr. Simmons said these schools often pursued COE accreditation for two reasons: to be compared with U.S. colleges and, in some cases, to allow them to recruit U.S. students to their programs.

“But I think one of the most important parts of foreign accreditation is it opened up discussions for understanding the profession in different countries. That’s why we worked with Mexico for years to understand their processes before (UNAM) even applied,” he said. “It was more than just going to the institution: ‘How do we understand your culture and educational process?’ There’s more value to accreditation than just for the institution.”

Plenty of confusion

Despite being a major topic of discussion, accreditation remains as mystifying as ever to most veterinarians.

For example, it may not be widely understood that the COE standards are designed to represent a minimum standard for entry-level veterinarians and that while all COE-accredited schools meet the standards, some exceed them.

Task force members noted: “Lack of familiarity with the intricacies of the accreditation process can contribute to individual perceptions of uneven application of accreditation standards, and such misunderstanding can be exacerbated by the necessary confidentiality adhered to by the COE.”

It should come as no surprise, then, that task force members asked for clarification in some areas of the accreditation process.

For one thing, they want the COE to make clearer the criteria for determining whether a veterinary school is part of a larger institution of higher learning—as required by Standard 1—or is a free-standing institution and, thus, not eligible for accreditation. Some AVMA members, for instance, have suggested that the Ross University School of Veterinary Medicine, which is located in St. Kitts, West Indies, may not qualify.

Dr. David E. Granstrom, director of the AVMA Division of Education and Research, points out that if Ross, which also runs a medical school, was not considered an institution of higher learning by the USDE, the COE wouldn’t be allowed to accredit its veterinary school.

Also, the task force sees a contradiction in the role the North American Veterinary Licensing Examination plays in accreditation. Although the test is not required for accreditation, there is a pass-fail threshold for schools whose graduating students generally take the examination. The task force believes that this use of the NAVLE creates an inconsistency that the COE should address.

Dr. Granstrom says the accreditation process includes a number of other outcomes assessment measures aside from the NAVLE, such as surveys of employers, alumni, and students as well as assessment rubrics that require faculty to observe students performing and mastering certain tasks.

However, he added that the council recently approved a new way to use NAVLE results. Instead of requiring a pass rate of 80 percent, each institution must fall within a 95 percent confidence interval around the pass rate for all accredited programs.

And finally, task force members believe that the accreditation standard on research, in conjunction with the supporting language in the COE Accreditation Policies and Procedures Manual, should be reviewed.

Increasing the quality of veterinary medicine globally improves veterinary medicine at all levels, and many members believe AVMA leadership in foreign veterinary school accreditation is important. In fact, those foreign veterinary schools that are accredited and those seeking accreditation stated that AVMA COE accreditation provides recognition of the highest standard of veterinary education worldwide and along with it the highest level of educational quality.

AVMA Task Force on Foreign Veterinary School Accreditation report

The standard currently states that “The college must maintain substantial research activities of high quality that integrate with and strengthen the profession program.” But, Dr. Coffman said, clarification is needed as to what is meant by “substantial” and “high quality.”

Currently, a COE subcommittee is looking at the standard to better define the elements of acceptable research programs, with results expected possibly as early as this summer. Any additional research metrics approved by the council will be added to the next version of the self-study template, which is published in the COE policies and procedures manual, Dr. Granstrom said.

Resource allocation

Though the task force came to a number of conclusions, it was not asked to make a recommendation on whether to continue foreign accreditation, which ultimately will be determined by the AVMA Executive Board.

Dr. Janver D. Krehbiel, AVMA Executive Board chairman and former COE member, said he feels the report was well-organized and included good illustrations that might be helpful for people in understanding the accreditation process.

The report also “gives us a sense of the extent to which there are benefits to foreign accreditation and how it impacts the veterinary profession, AVMA members, and the level of veterinary education globally,” he said.

Dr. Krehbiel said this impression was reinforced when AVMA leaders met with members of the Federation of Veterinarians of Europe after the Executive Board meeting in April.

“They (spontaneously) indicated that they appreciated our involvement and interest in veterinary education globally. That’s certainly consistent with AVMA’s mission and strategic plan and what we as a profession think is important,” Dr. Krehbiel said.

When the board gathers to address whether to continue foreign accreditation, one of the factors it will consider are the resources required to keep the process going, and task force members did look at how much the AVMA spends on foreign accreditation.

According to a report released by the AVMA in late 2011, budgeted expenses for all of the AVMA’s international activities in 2012 came to only 2.06 percent of the Association’s total expense budget, whereas budgeted income for international activities represented 2 percent of total budgeted income.

The financial impact of foreign accreditation has the potential to decrease further as the COE could begin sharing responsibility—and cost—with the Association of American Veterinary Medical Colleges.

“I think these are all questions that the board will look at very carefully. (Foreign accreditation) is an involved process, but we have some pretty thoughtful folks on this board, and we will be very conscientious in this review,” Dr. Krehbiel said. “The feedback from the COE and from the HOD and from blogs and members who have an interest in the topic will be critically important for the board to discuss and consider before making a decision.”

The report from the AVMA Task Force on Foreign Veterinary School Accreditation is available here.

AVMA members can post their comments about the report at the NOAH discussion board.